Effect of glucose–insulin–potassium on Plasma concentrations of C-reactive protein in acute ST- Elevation Myocardial Infarction; A Randomized Clinical Trial

Objective: the anti inflammatory effects of glucose–insulin–potassium (gik) in the management of patients with st segment elevation myocardial infarction (stemi) are controversial. we aimed to evaluate anti-inflammatory effect of gik in stemi patients treated with streptokinase which is not obvious up to now. methodology: this randomized clinical trial enrolled 72 patients who had stemi that were treated within 12 hours from symptom onset with a high dose of gik (25% glucose, 50 iu of soluble insulin per liter, and 80 m mol of potassium chloride per liter at 1 ml/kg/hour) (gik group) or normal saline (control group) as adjunct to thrombolytic therapy. we analyzed plasma concentrations of high-sensitivity c-reactive protein (hs crp) at baseline and sequentially for 48 hours. results: baseline hs crp were significantly increased (2- to 3-fold) at 24 and 48 hours in each group (p<0.01). there was no difference in plasma concentrations of hs crp between gik and control patients (p = 0.24). mean glucose level over 6 hours was higher in gik group than control group (p=0.006). conclusion: gik therapy offers no anti-inflammatory effect in patients with stemi treated with streptokinase.